Healthcare Provider Details

I. General information

NPI: 1922705888
Provider Name (Legal Business Name): HM ANDAR DO PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/10/2023
Last Update Date: 02/10/2023
Certification Date: 02/10/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1818 E DESERT INN RD
LAS VEGAS NV
89169-3209
US

IV. Provider business mailing address

1818 E DESERT INN RD
LAS VEGAS NV
89169-3209
US

V. Phone/Fax

Practice location:
  • Phone: 702-732-0178
  • Fax: 702-732-0179
Mailing address:
  • Phone: 702-732-0178
  • Fax: 702-732-0179

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QP3300X
TaxonomyPain Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: HAROON ANDAR
Title or Position: OWNER/PROVIDER
Credential: DO
Phone: 510-861-3990